Signature Page&01011 1�
BUILDING PERMIT DEPOSIT AGREEMENT
A 500.0 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. permits.
The City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
Iecti1 Theft of water service by the plumber, owner, or general contractor.
2 All permits have not been obtained.
All required inspections have not been obtained.
4 Occupancy occurs prior to a final inspection.
The project is completed without a final ins
on being done.
W-9 is not filled out for return of deposit
Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
I hereby agree to the above conditions and understand that should any or all
of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discretion of the City of Blair, Building and Inspections
Department.
N
Contractor/Owner Contractor/Owner
la -S -22 --
Date
City of Blair
Z0S10H sf
MUR.. WE 68081
____________________
Description___________
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1 362 OO
PERMIT PAYMENT
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ACCOUNT BN- . OO
CHECK PB PRMT
CHCK Received
1 362 UO
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.00
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FU 1O/O5/22 11,20 Rcpt# 9149O
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